Assess and create a discharge plan to ensure patient receives quality medical care.  Implement care strategies that are individualized for patients and directed toward the most appropriate and the least restrictive level of care Utilize both company and community-based resources to establish a safe and effective case management plan for hospitalized members and effective discharge planning to prevent readmissions Collaborate with patient, family, and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge plan Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided timely to all hospitalized members Advocate for patients and families as needed to ensure the patient’s needs and choices are represented and supported by the health care team Utilize approved clinical criteria (MCG and/or InterQual) to assess and determine appropriate level of care for hospitalized members Utilize approved insurance products, benefits, coverage limitations, insurance, and governmental regulations as it applies to the health plan Accountable to understand role and its effect on utilization management benchmarks and quality outcomes Work performed and completed onsite at various acute and alternative level of care facilities within the area Floating may require covering bases in another facility telephonically